青年与中老年缺血性脑卒中的临床特征分析

目的：探讨青年与中老年缺血性脑卒中的临床特征。方法：选取2021年4月—2022年3月广东省普宁市人民医院神经内科收治的530例缺血性脑卒中患者为研究对象，其中50例青年患者为观察组，480例中老年患者为对照组，记录两组患者危险因素、核磁共振(MRI)和血管学评估及转归判断。比较两组危险因素、病灶分布、血管狭窄分布及预后。结果：观察组患高血压比例低于对照组，抗心磷脂抗体阳性率高于对照组，差异有统计学意义(P<0.05)；两组患糖尿病、高脂血症、同型半胱氨酸、心房颤动、室间隔缺损的比例比较，差异无统计学意义(P>0.05)。观察组放射冠区、基底节区病灶占比高于对照组，差异有统计学意义(P<0.05)；两组脑叶、丘脑、脑干、小脑、胼胝体及其他多发病灶分布占比比较，差异无统计学意义(P>0.05)。两组大脑前动脉、大脑中动脉、大脑后动脉、基底动脉、椎动脉、颈内动脉、多发血管狭窄分布比较，差异无统计学意义(P>0.05)。观察组恢复良好率高于对照组，残疾、复发、死亡率均低于对照组，差异有统计学意义(P<0.01)。结论：青年与中老年缺血性脑卒中患者危险因素不...     

Combination Therapy with LXW7 and Ceria Nanoparticles Protects against Acute Cerebral Ischemia/Reperfusion Injury in Rats

Ischemia/reperfusion is known to greatly increase oxidative stress in the penumbra, which results in brain damage. Integrin αvβ3 is selectively up-regulated with ischemic injury to the brain and remains elevated throughout reperfusion. We determined whether or not a new compound biotinylated-LXW7-ceria nanoparticle (CeNP) (bLXW7-CeNP) plays a role in brain protection in the rat model of middle cerebral artery occlusion/reperfusion and shows better effects than CeNPs alone in improving the outcomes of focal oxidative stress and apoptosis more effectively. Male Sprague-Dawley rats were subjected to focal cerebral ischemia for 2 h followed by a 24-h reperfusion. Drug treatment was intravenously administered via the caudal vein 1 h after occlusion. Rats were randomly divided into the following 4 groups: bLXW7-CeNP treatment group (0.5 mg/kg); CeNP treatment group (0.5 mg/kg); control saline group; and sham group. Brains were harvested 24 h after reperfusion, and the neurologic deficit scores, infarction volume, blood-brain barrier (BBB) disruption, and the level of oxidative stress and apoptosis were determined. Results showed that the bLXW7-CeNP and CeNP treatments could improve neurologic deficit scores, infarction volume, BBB disruption, and the level of oxidative stress and apoptosis. Compound bLXW7-CeNP treatment exhibited better effects than CeNp treatment and showed remarkable statistical differences in the infarction volume, the degree of BBB breakdown, the apoptosis and oxidative stress, apart from neurologic deficit scores. Thus, we concluded that bLXW7-CeNP protects against acute cerebral ischemia/reperfusion injury. BLXW7, as a ligand of integrin αvβ3, may be able to effectively localize the anti-oxidant CeNPs to the ischemic penumbra region, which may provide more adequate opportunities for CeNPs to exert anti-oxidative stress effects and subsequently reduce apoptosis in acute cerebral ischemia/reperfusion.     

吲哚布芬联合氯吡格雷治疗急性缺血性脑卒中的疗效观察

〔摘 要〕 目的：分析研究吲哚布芬联合氯吡格雷治疗急性缺血性脑卒中的疗效。方法：选取普宁市人民医院 2018 年 12 月 至 2020 年 12 月期间收治的 68 例急性缺血性脑卒中患者。按照治疗方法的不同分为对照组与观察组,各 34 例。观察组给 予吲哚布芬联合氯吡格雷治疗,对照组给予阿司匹林联合氯吡格雷治疗。比较两组患者的治疗效果、美国国立卫生研究院 卒中量表（NIHSS）评分、Barthel 指数评分、不良反应发生率。结果：观察组患者治疗总有效率为 97.06 %,高于对照组 的 79.41 %,差异具有统计学意义（P ＜ 0.05）;治疗后观察组患者的 NIHSS 评分低于对照组,Barthel 指数高于对照组, 差异具有统计学意义（P ＜ 0.05）;观察组患者不良反应发生率为 2.94 %,低于对照组的 14.71 %,差异具有统计学意义 （P ＜ 0.05）。结论：吲哚布芬联合氯吡格雷治疗急性缺血性脑卒中具有降低神经功能缺损程度、提高生活自理能力的效果, 且患者治疗后不良反应比较少。